Wednesday, 30 September 2015

Evidence-BasedComplementaryandAlternativeMedicine

Special Issueon

Infertility:ART,MedicinalPlants,andAcupuncture

Medicinal plants and herbal formulas used to treat infertility have beenstudiedfor the support of pregnancies that have been achieved using artificialreproductivetechnologies(ART).Likewise,acupuncture’seffectsonpregnancyhavebeenstudied,particularlywhenappliedbeforeandafterinvitrofertilization(IVF).However,todatethereareonlyafewpapersthatexamineherbalsupportforfertility,andonlyonepaperthatpresentsfindingsofacupunctureandtraditionalChineseherbalmedicinecombinedtotreatinfertility.Practitionersoftenemploymorethanonetherapeuticinclinic.

We invite research and review papers describing current and expected usageofmedicinal
plants and acupuncture (used individually or concurrently) forART clients.
Clinical trials and clinical experiences are
welcome. Papers basedonclinicexperiencewouldneedtodevoteseveralparagraphstojustifyingtheirmethodological approach
and of course need patientconsent.

Highlights

CAM is used by a high proportion of people with an iatrogenic HCV infection.

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CAM use is similar between people with current and resolved HCV infection.

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The main CAM service used by people with iatrogenic HCV infection is reflexology.

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Key reasons for using CAM; relief from aches and pains/muscles problems and stress.

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Further research is required to determine the direct health benefits of CAM.

Summary

Introduction

A
cohort of people with iatrogenic HCV infection, current or resolved, in
Ireland have access to primary and secondary health care services,
including specified complementary and alternative medicine (CAM)
services, free of charge.

Objectives

Information
about their pattern of CAM usage and its association with various
demographic and lifestyle factors, and current HCV status, was sought as
part of a health and lifestyle survey, in order to provide information
for health service planning.

Design and methods

The
survey was carried out by self-administered postal questionnaire. The
level of CAM usage was compared to an age- and sex-matched sample of the
general population.

Results

The
response was 48% (720/1485). Compared to the general population, the
HCV population was significantly more likely to have attended a CAM
practitioner (50.1% vs 23.9%, OR 3.2; 95% CI 2.7–3.9). Within the HCV
population, multivariate analysis showed that females (OR 3.1; 95% CI
1.9–4.9), those who reported fibromyalgia (OR 2.7; 95% CI 1.8–3.9) and
those who reported anxiety (OR 1.4; 95% CI 1.0–2.0) were significantly
more likely to have used CAM, and smokers significantly less likely (OR
0.6; 95% CI 0.4–0.8). CAM attendance did not vary by current HCV status.
Reflexology, acupuncture and massage were the most commonly used forms
of CAM.

Conclusions

This study
demonstrates that CAM services are used by a high proportion of people
with iatrogenic chronic HCV. A more holistic approach to health care,
using a biopsychosocial model framework, may better meet the physical
and psychological health needs of this group.

Abstract

The
ability of plant phenolics to act as free radical scavengers has led to
increased interest in their ability to act as antioxidants in vivo.
Polyphenolic compounds, commonly present in hawthorn (Crataegus spp.),
as well as herbal preparations of hawthorn were examined using the TEAC
and DPPH assays to determine their antioxidant activity. Initial
results have shown the standards to be efficient free radical
scavengers. Quercetin dihydrate was found to be the most effective with
ability to inhibit up to 87.9% of the DPPH radical and over 90% of the
ABTS radical. The herbal preparations tested showed infusions of
hawthorn leaf and flower to be almost as effective with 82.9% of DPPH
radicals and 87.9% of ABTS radicals being inhibited. Most hawthorn
preparations are consumed orally, however, and the effect of
gastro-intestinal conditions on the ability of phenolic compounds to
scavenge free radicals is not taken into account. Both, the standards
and crude herbal preparations were exposed to simulated
gastro-intestinal conditions to determine their effect, if any, on
antioxidant activity. This study indicates that the scavenging activity
of hawthorn phenolics may be reduced by the digestive process. The
scavenging activity of Luteolin against ABTS radicals was found to have
decreased by 67.8%. The effect of the process on the herbal preparations
varied with the ability of the berry decoction to scavenge DPPH
decreasing by 43% while the scavenging of the leaf and flower infusion
decreased by only 1.94%.

Highlights

The domestic dog has naturally occurring disease conditions that closely mimic those of the human.

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Numerous data sets have been produced to date, although they are limited by either inclusion or analysis limitations.

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The
dog has much data available that could use coordination between
sources. There are also many areas of canine aging that have not been
thoroughly investigated, thereby leaving areas of study open for
further, new, or extended investigation.

Abstract

With
many caveats to the traditional vertebrate species pertaining to
biogerontology investigations, it has been suggested that a most
informative model is the one which: 1) examines closely related species,
or various members of the same species with naturally occurring
lifespan variation, 2) already has adequate medical procedures
developed, 3) has a well annotated genome, 4) does not require
artificial housing, and can live in its natural environment while being
investigated, and 5) allows considerable information to be gathered
within a relatively short period of time. The domestic dog
unsurprisingly fits each criterion mentioned. The dog has already become
a key model system in which to evaluate surgical techniques and novel
medications because of the remarkable similarity between human and
canine conditions, treatments, and response to therapy. The dog
naturally serves as a disease model for study, obviating the need to
construct artificial genetically modified examples of disease. Just as
the dog offers a natural model for human conditions and diseases, simple
observation leads to the conclusion that the canine aging phenotype
also mimics that of the human. Genotype information, biochemical
information pertaining to the GH/IGF-1 pathway, and some limited
longitudinal investigations have begun the establishment of the domestic
dog as a model of aging. Although we find that dogs indeed are a model
to study aging and there are many independent pieces of canine aging
data, there are many more “open” areas, ripe for investigation.

Highlights

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The present study reports the bioactive compounds from four Lamiaceae family plants: Agastache foeniculum, Lavandula angustifolia, Melissa officinalis and Nepeta cataria in two different stages of development and harvested in two distinctive periods of the day.

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Methanol extracts were analyzed for total polyphenolic and flavone/flavonol content using UV–vis spectrometry.

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Chromatographic
profile of phenolic acids and flavonoids were determined using high
performance liquid chromatography PDA detection.

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Antioxidant activity was evaluated using two different spectrophotometric methods.

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Optimum period of harvesting for maximum amount of bioactive compounds was determined.

Abstract

The
continuous interest in medicinal plants has brought about todays modern
processing and usage of different plants. Extracts obtained from the
aerial parts of Agastache foeniculum, Lavandula angustifolia, Melissa officinalis and Nepeta cataria
were investigated for their antioxidant activity and polyphenolic
content. The extracts were prepared from plants harvested in two
phenological phases of development (beginning of blooming and full
bloom) and in two distinctive time points (11 a.m. and 4 p.m.).
Different amounts of total phenolic content were measured
(12.44–76.43 mgGAE/g dry plant) and correlated with botanical origin,
phenophase and harvesting hour. Flavone/flavonol content presented
higher amounts than total polyphenol content in A. foeniculum
extracts (36.87 mgQE/g compared to 27.19 mgGAE/g). All plants exhibit
high antioxidant activity (73.14–81.74% inhibition and 0.265–0.554 mM
Trolox equivalents), measured with DPPH and FRAP method. Fingerprint of
biologically active compounds highlights the potential of using these
plants as value-added products, because of their content in phenolic
acids and flavonoids with antioxidant activity. The quantity and profile
of polyphenols was influenced by harvesting period and hour. The best
moment for harvesting these plants in order to have maximum amount of
bioactive compounds, was established to be in the first decade of June
(beginning of blooming) and in the afternoon.

Abstract

The
purpose of this three-group double-blind clinical trial study was to
investigate the effect of acupressure (指壓 zhǐ yā) with valerian (纈草 xié
cǎo) oil 2.5% on the quality and quantity of sleep in patients with
acute coronary syndrome (ACS) in a coronary intensive care unit (CCU).
This study was conducted on 90 patients with ACS in Mazandaran Heart
Center (Sari, Iran) during 2013. The patients were randomly assigned to
one of three groups. Patients in the acupressure with valerian oil 2.5%
group (i.e., valerian acupressure group) received bilateral acupoint (穴位
xué wèi) massage with two drops of valerian oil for 2 minutes for three
nights; including every point this treatment lasted in total 18
minutes. Patients in the acupressure group received massage at the same
points with the same technique but without valerian oil. Patients in the
control group received massage at points that were 1–1.5 cm from the
main points using the same technique and for the same length of time.
The quality and quantity of the patients' sleep was measured by the St.
Mary's Hospital Sleep Questionnaire (SMHSQ). After the intervention,
there was a significant difference between sleep quality and sleep
quantity in the patients in the valerian acupressure group and the
acupressure group, compared to the control group (p < 0.05).
Patients that received acupressure with valerian oil experienced
improved sleep quality; however, this difference was not statistically
significant in comparison to the acupressure only group. Acupressure at
the ear spirit gate (神門 shén mén), hand Shenmen, glabella (印堂 yìn táng),
Wind Pool (風池 fēng chí), and Gushing Spring (湧泉 yǒng quán) acupoints
can have therapeutic effects and may improve the quality and quantity of
sleep in patients with ACS. Using these techniques in combination with
herbal medicines such valerian oil can have a greater impact on
improving sleep and reducing waking during the night.

Graphical abstract

Keywords

acupressure;

acute coronary syndrome;

cardiac intensive care unit;

sleep quality;

sleep quantity;

valerian oil

1. Introduction

Cardiovascular
diseases are among the most common diseases in human societies and the
number of these patients has increased in recent decades.1
In 2008, coronary artery disease caused one of every six deaths in
America. On average, one American experiences cardiac events every 25
minutes, and one person dies every 1 minute.2
The emergence of cardiovascular diseases, especially coronary diseases,
is widely increasing in China, India, Pakistan, the East Mediterranean
region, and the Middle East; it is an important health and social
problem.3, 4, 5 and 6
Every year, approximately 3.6 million people are hospitalized in
hospitals under the Ministry of Health and Medical Education and
Treatment of Iran. A remarkable number of these patients have heart
disease, especially patients with acute coronary syndrome (ACS), which
includes acute myocardial infarction and unstable angina.7 Most sleep problems encountered by patients are because of their hospitalization.8
Many patients who are hospitalized in a coronary intensive care unit
(CCU) experience reduced quality and quantity of sleep with regard to
mental and environmental factors.9, 10, 11, 12 and 13
Even if environmental factors are controlled, patients with acute
myocardial infarction have an altered sleep structure (i.e., sleep
pattern) that can result from physiologic inflammatory changes or from
the nature of the myocardial infarction itself.14

Approximately 56% of the patients are sleep-deprived at the end of the 1st
day of hospitalization. Based on other studies, ACS patients have low
sleep quality during the first 3 days of their hospitalization.15 and 16
Comfortable sleep is difficult for patients hospitalized in intensive
care units because of constant monitoring, lighting on the unit, noise
due to the staff caring for other patients, mechanical ventilation,
frequent awakening by the nurses, the use of sedating and inotrope
drugs, disease severity, and the staff awakening patients early in the
morning in these units even though the patients need more sleep.9 Hospitalization can remarkably disturb the sleeping model.17

Sleep
is a primary need of human beings. It is necessary for maintaining
energy, appearance, and physical well-being. Sleep has an important role
in cardiovascular function. Its deprivation intensifies anxiety,
irritability, and anger, and increases the heart rhythm and myocardial
oxygen demand in a frequent and dangerous cycle.18 and 19 Insomnia can be treated by drugs, herbal medicine, psychotherapy, and physiological treatments.20 The most common way to treat or cope with sleeping problems is by using drugs. Based on research studies,11
there is no significant difference in sleep quality and quality of the
patients who use these drugs and patients who do not use them. The
effectiveness of drugless therapies is slower than the effectiveness of
sleep aids; however, drugless therapies are more permanent and do not
have the side effects of drugs such as memory deficits, drug resistance,
drug dependency, and drug addiction.

Insomnia can be treated by medication, herbal therapy, and psychological or physical therapy.20
Acupressure (指壓 zhǐ yā) can enhance comfort and sleep through massaging
and stimulating certain points in the head, hands, and back.21 Individuals can use this treatment method by themselves or with the help of other family members.22

A
traditional way of treating insomnia is by using valerian herb (纈草 xié
cǎo) self grown in nature plant. It is one of many plants used to treat
insomnia.23 The effect of valerian is similar to that of the benzodiazepines (e.g., its effect is comparable with that of 10 mg oxazepam24);
however, the adverse effects of valerian are fewer. When the human body
absorbs valerian, gamma-aminobutyric acid (GABA) receptor activity
increases.25 The result of a review article concluded that valerian could improve sleep quality with minimal or no adverse effect.26

Based
on available data, an article concerning the effectiveness of
acupressure with valerian oil on the quality and quantity of sleep in
patients with ACS has not been previously published. Because of the high
prevalence of insomnia in intensive care units and because of the
effect that acupressure has as a noninvasive and complementary method in
treating sleep disorders, the present study aimed to examine the effect
of acupressure with valerian oil on sleep quality and quantity in
patients hospitalized in a CCU, and thus improve sleep quality, health,
and life quality and satisfaction in patients with ACS.